ABSTRACT
The absorption of administered prostaglandin E2 (PGE2) into the term uterus was analysed, by measurement of intrauterine PGE2 and PGF 2 alpha, in 137 women. Amniotic fluid was sampled after elective Caesarean section, or at rupture of the membranes, and fetal membranes were collected after delivery of the placenta. Within 2 h of administration of a PGE2 pessary (500 micrograms), a significant elevation in amniotic fluid PGE2 was detected. Exogenous PGE2 stimulated the production of intrauterine PGE2 and PGF2 alpha, causing an elevated PGE2 concentration in amniotic fluid, and increased PGF2 alpha in fetal membranes. These studies indicate that the administration of as little as 500 micrograms of PGE2 pessary, resulted in elevated intrauterine PGE2. Exogenous PGE2 (2.5 mg) administration resulted in increased concentrations of PGF2 alpha in the fetal membranes. Considerable local release of PGs was observed at the site of membrane rupture, and this influenced the method of amniotic fluid sampling used in this study.
Subject(s)
Labor, Induced/methods , Prostaglandins E/pharmacokinetics , Administration, Intravaginal , Administration, Oral , Adult , Amniotic Fluid/metabolism , Dinoprost , Dinoprostone , Dose-Response Relationship, Drug , Extraembryonic Membranes/metabolism , Female , Humans , Placenta/metabolism , Pregnancy , Prostaglandins E/pharmacology , Prostaglandins F/pharmacokinetics , Uterus/metabolismABSTRACT
Prostaglandin F2 alpha and E2 concentrations in the amniotic fluid and fetal membranes of 35 patients was analysed, in order to investigate differences in prostaglandin synthesis in parous and nulliparous women, and to find whether women who subsequently required oxytocin to accelerate labour, showed any difference in intrauterine prostaglandin concentrations. Significantly less PGF2 alpha was detected in the amniotic fluid of women who required oxytocin, and fetal membrane PGE2 was significantly lower in these women at delivery. Differences in PGE2 and PGF2 alpha in parous and nulliparous women were less marked. Amniotic fluid levels of PGF2 alpha at Artificial Rupture of the Membranes (ARM), and the ratio of PGF2 alpha/PGE2 at ARM, were prognostic for the subsequent progression of labour.
